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Suicidal Thoughts or Threats

Topic Overview

Suicide
occurs almost twice as often as murder. Each year, about 36,000 people in the
United States die by suicide. In the U.S.:footnote 1

Suicide is the 10th leading cause of death.

Suicide is the third leading cause of death for
people ages 15 to 24 and the second leading cause for people ages 25 to
34.

Suicide rates have increased for middle-aged and older adults. One
suicide death occurs for every 4 suicide attempts.

Women try
suicide more often, but men are 4 times more likely to die from a suicide
attempt.

A gun is the most common method of suicide.

Many people have fleeting thoughts of death. Fleeting thoughts
of death are less of a problem and are much different from actively planning to
try suicide. Your risk of suicide is increased if you think about
death and killing yourself often, or if you have made a
suicide plan.

Most people who seriously
consider suicide do not want to die. Rather, they see suicide as a solution to
a problem and a way to end their pain. People who seriously consider suicide
feel hopeless, helpless, and worthless. A person who feels hopeless believes
that no one can help with a particular event or problem. A person who feels
helpless is immobilized and unable to take steps to solve problems. A person
who feels worthless is overwhelmed with a sense of personal failure.

Most people who seriously consider or attempt suicide have one or more of
the following risks:

Anytime someone talks about suicide or about wanting to die or
disappear, even in a joking manner, the conversation must be taken seriously. A
suicide attempt—even if the attempt did not harm the person—also must be taken
seriously. Don't be afraid to talk to someone you think may be considering
suicide. There is no proof that talking about suicide leads to suicidal
thinking or suicide. Once you know the person's thoughts on the subject, you
may be able to help prevent a suicide.

People who have suicidal
thoughts may not seek help because they feel they cannot be helped. This
usually is not the case. Many people with suicidal thoughts have medical
conditions that can be successfully treated. People who have suicidal thoughts
often have depression or substance abuse, and both of these conditions can be
treated. It is important to seek help when suicidal thoughts occur because
medical treatment usually is successful in diminishing these thoughts.

The possibility of suicide is most serious when a person has a plan for
suicide that includes:

Having the means, such as weapons or medicines,
available to try suicide or do harm to another person.

Having
set a time and place to try suicide.

Thinking there is no other
way to solve the problem or end the pain.

People who are considering suicide often are undecided about
choosing life or death. With compassionate help, they may choose to
live.

It can include acts like cutting, burning, or choking yourself on purpose, or pushing objects under your skin (like pieces of metal, glass, or wood). People doing these acts usually are not trying to kill themselves, but the results can still be dangerous.

Yes

Concerns about self-harm

No

Concerns about self-harm

Are you worried that feelings of depression or thoughts of suicide are not going away?

Yes

Feelings of depression or thoughts of suicide not going away

No

Feelings of depression or thoughts of suicide not going away

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

The National Suicide Hotline 1-800-273-8255 is also a resource.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

Try home treatment to relieve the
symptoms.

Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.

Home Treatment

If you are thinking about suicide,
talk to someone about your feelings. It is important to remember that there are
people who are willing and able to talk with you about your suicidal thoughts.
With proper treatment, most suicidal people can be helped to feel better about
life.

People for you to consider talking with include:

A family member, friend, or spiritual
adviser.

Your health professional, such as a doctor or
counselor.

Other mental health resources, such as a community
mental health agency or employee assistance program.

Your local
suicide hotline or the national suicide hotline: 1-800-273-TALK or 1-800-273-8255. You can also find information at www.suicidepreventionlifeline.org.

Tips for family and friends

You may be able to help
someone who is considering suicide.

If the suicide threat seems real, and the
person has a specific
suicide plan:

Call
911 (or the police if
911 is not available) in order to prevent
the person from carrying out the threat.

Consider your own safety.
If you are in a safe environment and the person will not harm you:

Stay with the person, or ask someone
you trust to stay with the person, until help arrives.

Don't argue
with the person or make statements like "It's not as bad as you think," and
don't challenge the person by saying "You're not the type to attempt suicide."
Arguing with the person may only increase his or her feelings of being out of
control of his or her life.

Talk about the situation as openly as
possible. Tell the person that you don't want him or her to die or to harm
another person. Show understanding and compassion.

If you think that someone you know has made a
suicide plan, call your health professional.

Your health professional may be able to
help identify a mental health specialist and arrange an appointment for a
person you think is considering suicide. An appointment with your health
professional may not be needed.

If you are not able to talk with
your health professional, call your local suicide hotline or the national
suicide hotline: 1-800-273-TALK or 1-800-273-8255.
You can also find information at www.suicidepreventionlifeline.org.

Once a treatment plan has been developed,
you may be able to assist the person get the help he or she needs.

Symptoms to watch for during home treatment

Call your doctor if any of the following symptoms occur before you see
your health professional:

The warning signs for the
suicide threat, such as having a plan for attempting suicide, are real.

Symptoms
become more severe or frequent.

Prevention

Suicide can be prevented. While some
suicides occur without warning, most do not. You can learn to recognize the
warning signs of suicide and take action when the signs are present. Take
action to evaluate your suspicions if you think that someone you know is
considering suicide.

The warning signs of suicide change with age.
Know the warning signs of suicide:

Take all warning signs seriously, even if the
suicidal threat or attempt seems minor. Take any conversation about suicide
seriously, even if the person mentions it in a joking manner.

Don't
be afraid to ask "What is the matter?" or bring up the subject of suicide.
There is no proof that talking about suicide leads to suicidal thinking or
suicide.

Be willing to listen. If a family member, friend, or
coworker talks about suicide or wanting to die or disappear, even in a joking
manner, the conversation must be taken seriously. Once you know the person's
thoughts on the subject, you may be able to help prevent a
suicide.

Help the person make arrangements to see a doctor or
mental health professional immediately.

Since a suicidal person may feel he or she
cannot be helped, you may have to take an active role in finding a health
professional and getting the person to the appointment.

If you are
unfamiliar with mental health resources in your area, a doctor, counselor,
community mental health agency, local suicide hotline, or the national suicide
hotline (1-800-273-TALK or 1-800-273-8255)
may be able to help
identify a health professional. You can also find information at www.suicidepreventionlifeline.org.

Make sure the person will have
someone with him or her at all times until contact is made with a mental health
professional.

Help the person identify other potential sources of
support from people who care about him or her, such as family, friends, or
spiritual adviser.

Follow up to find out how the person's treatment is
going. A suicidal person may be reluctant to seek help and may not continue
with treatment after the first visit with a health professional. Your support
may help the person decide to continue treatment.

Remove all guns
from the home. Guns are the most common method used. Studies have shown that suicide
attempts are more likely to lead to death in homes that have a gun, even if the
gun is kept unloaded and securely locked up.

Discard all
prescription and nonprescription medicines that are not currently being
used.

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (2012). Suicide: Fact sheet. Available online: http://www.cdc.gov/ViolencePrevention/suicide/index.html.

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